Stages of the Process

After a claim is filed and the applicant is found to meet the basic criteria, a professional assessor (nurse or physiotherapist) will visit the claimant's home to determine the extent of his/her dependence on others and the level of supervision he/she requires.

The visit will take place approximately two weeks after the National Insurance Institute receives the claim form and in most cases will be coordinated in advance. On the short term track, one can change the date of the visit by contacting The National Insurance Institute's Counseling Center for the Elderly or by calling the national call center at *6050.

For those with cognitive decline, the functioning assessment will be performed in the presence of a family member or someone else who knows the claimant well and on a daily basis. For more information about accommodations made for those with dementia and alzheimer's see ADL Dependence Test for Alzheimer's Patients.

Claimants are asked to provide photo identification, the medications they currently take, assistive devices they use (such as a walking stick) and any other medical documentation they may have. Claimants are asked to provide details of their daily schedule: when and how they get up; how they sleep at night; how they get to the bathroom and manage going to the bathroom during the day and at night; whether or not they get help on a daily basis and if so, from who; how they manage when they cannot get help; how they manage shopping and preparing food; how they get dressed; what are their problems when functioning in different capacities and what causes them.

If necessary, claimants are asked to perform actions that reflect their functioning capacity (not any actions that may harm their well-being). They are asked to put garments on over what they are already wearing, and put on socks (this can be performed in private if requested). Those who are mobile are requested to go to the bathroom, wash their hands with soap, rinse and dry their face, go to the kitchen, heat up food and serve it at the table.

Those who have difficulty performing an action not generally examined according to the standard examination process will be requested to perform this action.

Example

An elderly man who gets up from his seat without assistance says that he requires assistance in order to sit on the toilet and get up from it. The assessor will request that the man sit on the toilet in order to examine the issue. The assessor may then realize that the toilet is too low and recommend that a special device be added to the toilet to make it higher, thus alleviating the problem.

At the end of the visit, the assessor will pass the test results to the National Insurance Institute.

Continuing the Process

Next Step

Additional Information

Instructions

A National Insurance Institute clerk will prepare a summary and determine if the claimant is eligible for a Long-Term Care Benefit

For those who qualify for the benefit, eligibility will be determined as temporary or permanent, and given a level - Level 1, 2, 3, 4, 5, or 6.

Notification of the test's outcome

The decision will be sent in the mail within two weeks from the date of the ADL dependency test home visit

If a person is granted eligibility for a Long-Term Care Benefit, a nurse, social worker or health clinic will conduct a home visit to assess the services that should be provided according to which the committee will determine what services to provide.

The maximum duration of time it should take to handle a claim is approximately 60 days, from the first of the month after the submission of the claim (in most cases the service benefits are granted about a month after filing the claim.)

If you are not satisfied with the decision issued following the ADL test (in case of rejection or if you think the granted level of eligibility is too low), the decision can be appealed to an appeals committee.

The *8840 hotline run by the Ministry for Social Equality gives the elderly a central address to direct all of their questions, provide information regarding rights, services and benefits entitled to the elderly. It also helps them actualize these rights.

The *8840 hotline run by the Ministry for Social Equality gives the elderly a central address to direct all of their questions, provide information regarding rights, services and benefits entitled to the elderly. It also helps them actualize these rights.